A patient with advanced gastric cancer complicated with pyloric obstruction was treated using D2 ＋ radical resection combined with perioperative chemotherapy, and had satisfying outcomes. The perioperative chemothera...A patient with advanced gastric cancer complicated with pyloric obstruction was treated using D2 ＋ radical resection combined with perioperative chemotherapy, and had satisfying outcomes. The perioperative chemotherapy regimen was Taxol and S1 （tegafur, gimeracil, and oteracil）. Three cycles of neoadjuvant chemotherapy were delivered before surgery, and three cycles of adjuvant therapy after surgery. PR was achieved after chemotherapy. D2 ＋ dissection of stations 8p, 12b, 12p, 13 and 14v lymph nodes was performed on September 10, 2012.展开更多
AIM:To evaluate the safety and efficacy of partially covered self-expandable metallic stents(SEMSs)in benign pyloric obstruction.METHODS:We retrospectively analyzed data from 10consecutive patients with peptic ulcer-r...AIM:To evaluate the safety and efficacy of partially covered self-expandable metallic stents(SEMSs)in benign pyloric obstruction.METHODS:We retrospectively analyzed data from 10consecutive patients with peptic ulcer-related pyloric obstructive symptoms(gastric outlet obstruction scoring system(GOOSS)score of 1)between March 2012and September 2013.The patients were referred to and managed by partially covered SEMS insertion in our tertiary academic center.We assessed the technical success,symptom improvement,and adverse events after stenting.RESULTS:Early symptoms were improved just 3 d after SEMS placement in all 10 patients.The GOOSS score of all patients improved from 1 to 3.There were no serious immediate adverse events.The overall rate of being symptom free was 90%at a median of 11mo of follow-up(range:4-43 mo).Five patients were managed by a rescue SEMS because of failure of previous endoscopic balloon dilatation.Among them,four patients had sustained symptom improvement after the SEMS procedure.During the follow-up period,migration of the SEMS was observed in two patients(20.0%),both of whom had previous endoscopic balloon dilatation before SEMS insertion.CONCLUSION:Despite the small number in this study,partially covered SEMSs showed a favorable and safe outcome in the treatment of na?ve benign pyloric obstruction and in salvage treatment after balloon dilatation failure.展开更多
BACKGROUND Heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign disease.Reports of malignant change of heterotopic pancreas are scarce.CASE SUMMARY A 44-year-o...BACKGROUND Heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign disease.Reports of malignant change of heterotopic pancreas are scarce.CASE SUMMARY A 44-year-old Chinese female underwent a gastroscopy to assess abdominal distension that had persisted for 2 months.A protruding lesion in the gastric antrum was revealed but no malignant tissue was found in the biopsy specimen.The patient's symptom persisted and progressed to repeated vomiting.Endoscopy after 4 months revealed obstruction of the gastric outlet caused by the protruding lesion.A distal gastrectomy was performed.Histopathological examination of the surgical specimen showed the malignant transformation of aberrant pancreas in the stomach.Chemotherapy consisting of folinic acid,fluorouracil,and oxaliplatin was administered for three cycles,and was changed to gemcitabine monotherapy because of adverse effects and increased serum tumor marker levels.The patient remained asymptomatic during a 12-month follow-up.CONCLUSION Pancreatic heterotopy should be considered as source of a potentially malignant lesion,and early treatment or close monitoring for aberrant pancreas is recommended.展开更多
Objective To relieve long-term malnutrition caused by a malignant tumor affecting the pylorus and to prolong the patient survival.Methods A patient presented with complete pyloric obstruction due to pyloric tumors,and...Objective To relieve long-term malnutrition caused by a malignant tumor affecting the pylorus and to prolong the patient survival.Methods A patient presented with complete pyloric obstruction due to pyloric tumors,and achieved good therapeutic effects through nutritional support and effective chemotherapy.Results After about 40 days of treatment,all physiological indicators were improving.After chemotherapy,the pyloric tumor shrank and the complete obstruction was relieved.The patient was able to eat and drink normally.Conclusion Nutritional support,combined with chemotherapy,may effectively treat complete pyloric obstruction caused by advanced tumors.展开更多
文摘A patient with advanced gastric cancer complicated with pyloric obstruction was treated using D2 ＋ radical resection combined with perioperative chemotherapy, and had satisfying outcomes. The perioperative chemotherapy regimen was Taxol and S1 （tegafur, gimeracil, and oteracil）. Three cycles of neoadjuvant chemotherapy were delivered before surgery, and three cycles of adjuvant therapy after surgery. PR was achieved after chemotherapy. D2 ＋ dissection of stations 8p, 12b, 12p, 13 and 14v lymph nodes was performed on September 10, 2012.
文摘AIM:To evaluate the safety and efficacy of partially covered self-expandable metallic stents(SEMSs)in benign pyloric obstruction.METHODS:We retrospectively analyzed data from 10consecutive patients with peptic ulcer-related pyloric obstructive symptoms(gastric outlet obstruction scoring system(GOOSS)score of 1)between March 2012and September 2013.The patients were referred to and managed by partially covered SEMS insertion in our tertiary academic center.We assessed the technical success,symptom improvement,and adverse events after stenting.RESULTS:Early symptoms were improved just 3 d after SEMS placement in all 10 patients.The GOOSS score of all patients improved from 1 to 3.There were no serious immediate adverse events.The overall rate of being symptom free was 90%at a median of 11mo of follow-up(range:4-43 mo).Five patients were managed by a rescue SEMS because of failure of previous endoscopic balloon dilatation.Among them,four patients had sustained symptom improvement after the SEMS procedure.During the follow-up period,migration of the SEMS was observed in two patients(20.0%),both of whom had previous endoscopic balloon dilatation before SEMS insertion.CONCLUSION:Despite the small number in this study,partially covered SEMSs showed a favorable and safe outcome in the treatment of na?ve benign pyloric obstruction and in salvage treatment after balloon dilatation failure.
基金The authors thank Mr.Yong-Jian Deng,Department of Pathology,Nanfang Hospital。
文摘BACKGROUND Heterotopic pancreas is a common lesion found in the gastrointestinal tract and is usually considered a benign disease.Reports of malignant change of heterotopic pancreas are scarce.CASE SUMMARY A 44-year-old Chinese female underwent a gastroscopy to assess abdominal distension that had persisted for 2 months.A protruding lesion in the gastric antrum was revealed but no malignant tissue was found in the biopsy specimen.The patient's symptom persisted and progressed to repeated vomiting.Endoscopy after 4 months revealed obstruction of the gastric outlet caused by the protruding lesion.A distal gastrectomy was performed.Histopathological examination of the surgical specimen showed the malignant transformation of aberrant pancreas in the stomach.Chemotherapy consisting of folinic acid,fluorouracil,and oxaliplatin was administered for three cycles,and was changed to gemcitabine monotherapy because of adverse effects and increased serum tumor marker levels.The patient remained asymptomatic during a 12-month follow-up.CONCLUSION Pancreatic heterotopy should be considered as source of a potentially malignant lesion,and early treatment or close monitoring for aberrant pancreas is recommended.
基金This work was supported by the National Natural Science Foundation of China(81870458)the Yunnan Engineering Technology Center of Digestive Disease(2018DH006)+2 种基金the Yunling Scholar(YLXL20170002)the Education Department of Yunnan Province(2019Y0352)the Health Department of Yunnan Province(2018NS0084).
文摘Objective To relieve long-term malnutrition caused by a malignant tumor affecting the pylorus and to prolong the patient survival.Methods A patient presented with complete pyloric obstruction due to pyloric tumors,and achieved good therapeutic effects through nutritional support and effective chemotherapy.Results After about 40 days of treatment,all physiological indicators were improving.After chemotherapy,the pyloric tumor shrank and the complete obstruction was relieved.The patient was able to eat and drink normally.Conclusion Nutritional support,combined with chemotherapy,may effectively treat complete pyloric obstruction caused by advanced tumors.
